Socioeconomic Inequality in Screen Time, Phone, and Tablet Use among Iranian Adolescents: Results of A National Study.

Background: Excessive screen time has been associated with a variety of negative health outcomes. We aimed to evaluate screen time and phone and tablet use in Iranian adolescents and their relation to the socioeconomic status of adolescents' families in 2018. Methods: This descriptive-analytical study was carried out on 10-12-year-old adolescents from Kurdistan, Fars, and Markazi provinces. Cluster sampling was used for sampling. Data were collected by completing demographic questionnaires, calculating the BMI of adolescents and phone and tablet use, screen time, and socioeconomic status of the families. We used linear and logistic regression to estimate the final model. The concentration index was used to measure inequality and the Oaxaca decomposition to examine the different determinants of the inequality. Results: 1590 adolescents (52.58% boys) were enrolled in our study. Screen time activities were significantly higher in boys, older adolescents, higher BMIs, more educated mothers, and 35< year-old fathers (P < 0.05). The use of mobile phones and tablets was significantly higher among boys, ten-year-olds, families with four or fewer members, higher BMIs, adolescents with higher levels of parental education, and more educated mothers (P < 0.05). In addition, the concentration index for screen time activities (C = 0.083) and phone and tablet use (C = 0.536) showed that screen time and phone and tablet use activities were higher in adolescents with high socioeconomic status. Conclusion: Screen time, phone and tablet use were higher in adolescents with high socioeconomic status. Also, many other factors like gender, age, BMI, parents' education and age can affect screen time, phone and tablet use in adolescents.

Nursing care based on the Support-Based Spiritual Care Model increases hope among women with breast cancer in Iran.

PURPOSE: Taking care of cancer patients and treating them are among major challenges in the field of health. Several studies have shown that promotion of hope is an efficient strategy for effectively treating this group of patients, reducing their symptoms, and improving the quality of their life. It seems that spiritual care can boost hope in these patients. This study aims to determine the effects of nursing care based on the Support-Based Spiritual Care Model on boosting hope among women with breast cancer. METHODS: In this controlled clinical trial, 72 patients with breast cancer were selected through consecutive sampling and randomly assigned to two control and intervention groups (n = 36 in each group) based on four randomized blocks. The intervention was carried out based on the Support-Based Spiritual Care Model for the patients and their main caregivers in six sessions. Besides, the Snyder's hope scale was completed before and 1 month after the intervention by the participants in the intervention and control groups. RESULTS: The results of the independent samples t-test showed no significant difference in the mean scores of hope between the intervention and control groups before the intervention (P > 0.05). However, after the intervention, the mean scores of hope for the intervention and control groups were 46.71 ± 4.61 and 40.40 ± 5.42, respectively, showing a significant intergroup difference as verified by the independent samples t-test (P < 0.05). CONCLUSION: According to the results of this study, providing nursing care based on the Support-Based Spiritual Care Model can raise hope in patients with breast cancer. CLINICAL IMPLICATIONS: Healthcare professionals can boost hope in cancer patients through proper planning and adequate support in providing nursing care based on the proposed model.

Prevalence of Listeria monocytogenes infection in women with spontaneous abortion, normal delivery, fertile and infertile.

BACKGROUND: Listeria monocytogenes with a vast range of natural reservoirs is more known for being a food-borne pathogen. Human infections have shown an impact on pregnancy outcomes, so, this study surveyed the frequency of L. monocytogenes infection involving different groups of women. METHODS: This study enrolled a total sample consisting of 109 women with spontaneous abortion, 109 women with normal delivery, 100 fertile women, and 99 infertile women aged 19-40 years and willing to participate in the study. The research tool in this study was a questionnaire and Polymerase chain reaction (PCR) test. RESULTS: According to the results, the frequency of L. monocytogenes infection was 4/109 (3.66%) observed among women with spontaneous abortion, 2/109 (1.83%) among women with normal delivery, 3/100 (3%) among fertile women, and 0/99 (0%) among infertile women. CONCLUSION: There was no significant relationship between Listeria monocytogenes infection and pregnancy outcomes of spontaneous abortion and infertility.

Global prevalence of HCV and/or HBV coinfections among people who inject drugs and female sex workers who live with HIV/AIDS: a systematic review and meta-analysis.

Coinfections of hepatitis C virus (HCV) and/or hepatitis B virus (HBV) with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) are associated with high morbidity and mortality and poor prognosis. The main objective of this study was to evaluate the prevalence of HCV and/or HBV coinfections among people who inject drugs (PWID) and female sex workers (FSWs) who live with HIV/AIDS worldwide. Data sources were searched from January 2008 to October 2018 in different databases, including PubMed, Scopus, Web of Science, Embase, and Ovid. Data were analyzed in Stata 14 software using the Metaprop command. The results showed that the prevalence of HCV among PWID and FSWs with HIV/AIDS was 72% (95% CI: 59%-83%) and 40% (95% CI: 0%-94%), respectively. The prevalence of HBV among PWID and FSWs with HIV/AIDS was 8% (95% CI: 5%-13%) and 2% (95% CI: 0%-7%), respectively, and the prevalence of HCV/HBV in PWID with HIV/AIDS was 11% (95% CI: 7%-15%). The highest prevalence of HCV was observed in PWID in the Eastern Mediterranean and Europe regions, and the lowest was observed in the Africa region. The South-East Asia region had the highest prevalence of HBV among PWID, and the Africa region had the lowest prevalence. The high prevalence of HCV coinfection among PWID and FSWs with HIV/AIDS was an alarming health problem and requires appropriate interventions. Therefore, considering that these populations are key populations for HCV elimination, it is recommended to screen them regularly for HCV. In addition, harm reduction and HBV vaccination should be carefully considered.

The Effects of L-Carnitine on Echocardiographic Changes in Patients With ß-Thalassemia Major and Intermedia.

INTRODUCTION: Heart failure, fatal arrhythmias, and cardiac dilatation because of anemia are common causes of ß-thalassemia major-related deaths. The aim of this study was to determine the effect of L-carnitine on echocardiographic changes in ß-thalassemia major and intermedia patients in Besat Hospital in Sanandaj, Iran. METHODS: In a randomized clinical trial, 60 ß-thalassemia patients who were eligible for L-carnitine administration were randomly divided into 2 placebo and study drug groups. The duration of the study was 6 months. Using echocardiography and blood tests, cardiac parameters including left ventricular dilatation, left ventricular hypertrophy, and a number of cardiac blood indices were examined before and after the intervention. The data were analyzed using SPSS V.23 software, χ, and covariance statistical tests. RESULTS: There was no significant difference between the 2 groups in terms of age and sex. Patients treated with L-carnitine have a reduced rate of left ventricular dilatation, left ventricular hypertrophy, and systolic blood pressure compared with controls (P<0.05). Cardiac output increased from 43.5 to 56.5 (P=0.002). CONCLUSIONS: The results of this study showed that the drug has a positive effect on the improvement of cardiac indices in ß-thalassemia patients. Therefore, we suggest that further studies with more samples and other diagnostic modalities of the drug's effect be investigated.

Survival rate of patients with bladder cancer and its related factors in Kurdistan Province (2013-2018): a population-based study.

BACKGROUND: Bladder cancer is one of the most common urinary tract cancers. This study aims to estimate the survival rate of patients with bladder cancer according to the Cox proportional hazards model based on some key relevant variables. METHODS: In this retrospective population-based cohort study that explores the survival of patients with bladder cancer and its related factors, we first collected demographic information and medical records of 321 patients with bladder cancer through in-person and telephone interviews. Then, in the analysis phase, Kaplan-Meier method and log-rank test were used to draw the survival curve, compare the groups, and explore the effect of risk factors on the patient survival rate using Cox proportional hazards model. RESULTS: The median survival rate of patients was 63.2 (54.7-72) months and one, three and five-year survival rates were 87%, 68% and 54%, respectively. The results of multiple analyses using Cox's proportional hazards model revealed that variables of sex (male gender) (HR = 11.8, 95% CI: 0.4-100.7), more than 65 year of age (HR = 4.1, 95% CI: 0.4-11), occupation, income level, (HR = 0.4, 95% CI: 0.2-0.8), well differentiated tumor grade (HR = 3.2, 95% CI: 1.7-6) and disease stage influenced the survival rate of patients (p < 0.05). CONCLUSION: The survival rate of patients with bladder cancer in Kurdistan province is relatively low. Given the impact of the disease stage on the survival rate, adequate access to appropriate diagnostic and treatment services as well as planning for screening and early diagnosis, especially in men, can increase the survival rate of patients.

A pilot randomized controlled trial to assess the effect of Islamic spiritual intervention and of breathing technique with heart rate variability feedback on anxiety, depression and psycho-physiologic coherence in patients after coronary artery bypass surgery.

BACKGROUND: This study investigated the effects of Islamic religious and breathing techniques with heart rate variability (HRV) biofeedback therapies on HRV and psycho-physiologic coherence (resonance frequency), depression and anxiety in coronary artery bypass graft surgery (CABG) patients. METHODS: Sixty CABG patients were chosen and randomly assigned to religious, breathing techniques and control groups. The experimental groups received 8  weeks of treatments; a 2-h session with home works in each week. The control group received only their normal hospital interventions. The groups' depression, anxiety, HRV and psycho-physiologic coherence levels were assessed before and after the interventions by DASS-21 for depression and anxiety, and em-wave desktop software for HRV and psycho-physiologic coherence. The data were analyzed using ANCOVA with Bonferroni Comparison test and descriptive tests in SPSS software. RESULTS: The findings showed that there were significant differences in psycho-physiologic coherence (HRV), depression and anxiety scores among the three groups in the post-tests. In fact, depression and anxiety were reduced more in the religious group, while psycho-physiologic coherence raised more in the breathing with the HRV feedback group. CONCLUSION: The results showed that both Islamic religious and breathing techniques with HRV biofeedback therapies can be used in rehabilitation programs for CABG patients in clinics and hospitals.

The determinants of methadone maintenance treatment in opioids dependence users: A survival analysis study.

Background: Staying in treatment is one of the basic principles in maintenance treatment with methadone and it is considered as a success criterion in the treatment procedure. This study aimed at analyzing effective determinants on staying in treatment in methadone treatment procedure. Methods: This was a retrospective cohort study, in which 6 MMT centers were randomly selected to be studied. The data were collected using the patients' medical records. Therefore, 1008 medical record files belonging to the patients who received methadone treatment from April 2013 to August 2017 were investigated. Proportional hazard Cox regression (extended) was used to specify the determinants of the methadone maintenance treatment and STATA 11 was used for data analysis. Results: The patients' mean age was 38.8 years (±1.08), and 75.8% were married and only 39.1% had full-time jobs. The mean age for the first substance abuse was at 24.31years (±7.93). The average time of staying in the treatment was 28.8 months. The results of the adjusted Cox proportional hazards regression showed among the 14 variables entered into the model, in the 1-12-month interval age of first drug use (HR=0.945, 95 % CI=0.908-0.983, p=0.005), specific drug use (HR=1.14, 95 % CI=1.026-1.268, p=0.014), and the frequency of treatment (HR=0.974, 95 % CI=0.959-0.990, p=0.002) were significantly correlated with survival status. The 13-36- month interval drug use (HR=0.931, 95 % CI=0.886-0.978, p=0.005) was significantly correlated with survival status. Also, the range of 37-53 month drug use (HR=1.058, 95 % CI=1.001-1.119, p= .044) had a significant relationship with survival status. Conclusion: This study showed age of first drug use, specific drug use, the frequency of treatment and drug use were correlated with a decrease in staying duration in treatment. Therefore, taking these factors into consideration in designing and administering various interventions in addiction treatment and consulting centers is of paramount importance.

Immunofluorescent labeling of CD20 tumor marker with quantum dots for rapid and quantitative detection of diffuse large B-cell non-Hodgkin's lymphoma.

Fluorescent semiconductor quantum dots (QDs) are newfound nanocrystal probes which have been used in bioimaging filed in recent years. The purpose of this study is to evaluate the diagnostic value of specific QDs coupled to rituximab monoclonal antibody against CD20 tumor markers for patients with diffuse large B-cell lymphoma (DLBCL). In current study rituximab-conjugated quantum dots (QDs-rituximab) were prepared against CD20 tumor markers for detection of CD20-positive cells (human Raji cell line) using flowcytometry. A total of 27 tumor tissue samples were collected from patients with DLBCL and 27 subjects with negative pathological tests as healthy ones, which stained by QD-rituximab. The detection signals were obtained from QDs using fluorescence microscopy. The flowcytometry results demonstrated a remarkable difference in fluorescent intensity and FL2-H + (CD20-positive cells percentage) between two groups. Both factors were significantly higher in Raji in comparison with K562 cell line (P < 0.05). Lot of green fluorescence signals was observed due to the selectively binding of QD-rituximab to CD20 tumor markers which overexpressed in tumor tissues and a few signals observed on the defined healthy ones. Based on these observations the cut-off point was 46.8 dots and the sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 89.5%, 91.3%, and 100%, respectively (LR+, 9.52; LR-, 0). The QD -rituximab could be beneficial as a bioimaging tool with high sensitivity to provide an accurate molecular imaging technique for identifying CD20 tumor markers for early diagnosis of the patients with DLBCL.

The association between circulating 25-hydroxyvitamin D and cardiovascular diseases: a meta-analysis of prospective cohort studies.

BACKGROUND: There is a controversy about the association between vitamin D and cardiovascular diseases (CVDs). The effect of serum 25-OH-vitD on the risk of CVDs was evaluated. METHODS: Major electronic databases including Scopus, Science Direct, and PubMed were searched. All prospective cohort studies on the relationship between vitamin D status and CVDs conducted between April 2000 and September 2017 were included, regardless language. The study participants were evaluated regardless of their age, sex, and ethnicity. The Newcastle-Ottawa Scale was used to assess the quality of the studies. Two investigators independently selected the studies and extracted the data. The designated effects were risk ratio (RR) and hazard ratio (HR). The random effects model was used to combine the results. RESULTS: A meta-analysis of 25 studies with 10,099 cases of CVDs was performed. In general, a decrease in the level of vitamin D was associated with a higher relative risk of CVDs (incidence-mortality combined) (RR = 1.44, 95% CI: 1.24-1.69). This accounts for 54% of CVDs mortality rate (RR = 1.54, 95% CI: 1.29-1.84(. However, no significant relationship was observed between the vitamin D status and incidence of CVDs (RR = 1.18, 95% CI: 1-1.39). In general, low serum vitamin D level increased the risk of CVD by 44% (RR = 1.44, 95% CI: 1.24-1.69). It also increased the risk of CVD mortality (RR = 1.54, 95% CI: 1.29-1.84) and incidence rates (RR = 1.18, 95% CI: 1-1.39). CONCLUSIONS: The findings showed that vitamin D deficiency increases the CVDs mortality rate. Due to the limited number of studies on patients of the both genders, further research is suggested to separately evaluate the effect of vitamin D status on CVD in men and women.

Predicting vitamin E and C consumption intentions and behaviors among factory workers based on protection motivation theory.

BACKGROUND: Study of antioxidant vitamin consumption behavior, especially in high-risk groups with high exposure to toxic metals to reduce metal toxicity, is emphasized. This study aims to examine the structural relationships between knowledge, protection motivation theory constructs, and vitamin E and C consumption behavior among cement factory workers. METHODS: Protection motivation theory and food frequency questionnaires were completed by 420 factory workers. Data were subjected to structural equation modeling to examine associations between knowledge, protection motivation theory constructs, and vitamin E and C consumption behavior. Efficacy of current recommended models was also explored. RESULTS: Structural equation modeling showed high explained variance within the constructs of protection motivation theory for vitamin E and C consumption behavior and intention (56-76%). The overall fit of the structural models was acceptable for both vitamin E and C behavior. Knowledge, self-efficacy, response efficacy, and perceived vulnerability predicted intention, which in turn predicted vitamin consumption behavior. Significant relationships between knowledge and self-efficacy, response efficacy, perceived vulnerability, and perceived severity were also found, while self-efficacy and response efficacy showed significant relationships with vitamin E and C consumption behavior. CONCLUSIONS: Considering that response efficacy, self-efficacy, and intention showed as strong predictors of vitamin E and C consumption behavior, specific attention should be paid to coping appraisals and intention when designing intervention plans. Additionally, establishing the predicting role of knowledge for protection motivation theory constructs and protective behaviors should be integrated into intervention programs.

A Clinical Trial of the Effect of Warm Intravenous Fluids on Core Temperature and Shivering in Patients Undergoing Abdominal Surgery.

PURPOSE: This study was conducted to investigate the effect of warm intravenous fluids on shivering and core temperature of patients undergoing abdominal surgery. DESIGN: This study was a two-group clinical-control trial. METHODS: Ringer's solution at normal room temperature and serum at 38°C were infused in the control and intervention groups, respectively. Shivering, core temperature, SpO2, and vital signs were measured at admission to the operating room and postanesthesia care unit (PACU) and 30 minutes after the admission to the PACU. FINDINGS: There was a significant difference between the two groups in terms of shivering, core temperature, and pulse rate at the time of admission to the PACU and 30 minutes after. CONCLUSIONS: Ringer's solution at 38°C instead of room temperature can be used to reduce the incidence of postanesthetic hypothermia and shivering in patients undergoing abdominal surgery. Using this method in addition to other nursing care is recommended preoperatively.

Development and psychometric properties of a questionnaire to measure drug users' attitudes toward methadone maintenance treatment (DUAMMT) in Iran.

BACKGROUND: Assessing drug users' attitudes towards different kinds of addiction treatment is necessary to design tailored strategies. The aim of the present study is to develop and examine the psychometric properties of a new scale, called the DUAMMT, for assessing drug users' attitudes toward methadone maintenance treatment in Iran. METHODS: A multi-phase development method was applied in developing an instrument from February to December 2016. The item generation and scale development were performed through literature review, a qualitative approach, and interviews with an expert panel. Then, the psychometric properties of the scale were evaluated by means of cross-sectional studies with drug users. We performed an exploratory factor analysis, a confirmatory factor analysis, and item-scale correlations; and we tested the internal consistency of the scale. Furthermore, test-retest reliability was evaluated among an Iranian sample of drug users. RESULTS: The mean age of participants was 34.12 years. The exploratory factor analysis revealed four factors (perceived barriers, perceived concerns, methadone side effects, and perceived positive effects) containing 17 items that jointly accounted for 60.53% of the observed variance. The confirmatory factor analysis showed a model with appropriate fitness for the data. The Cronbach's alpha coefficient for the subscales ranged from .70 to .79. The intra-class correlation coefficient (ICC) ranged from .774 to .970, which is well above the acceptable threshold. CONCLUSIONS: The findings of the present study suggest that the DUAMMT is a valid and reliable instrument to measure drug users' attitudes toward methadone maintenance treatment. The DUAMMT can be applied at the start of treatment so that clinical intervention can be targeted to promote retention in treatment.

Association of p53 codon 72 Arg>Pro polymorphism and risk of cancer in Iranian population: A systematic review and meta-analysis.

Background: Different studies have investigated the association between p53 codon 72 Arg>Pro polymorphism and cancer risk. Because of the lack of consensus of the results in individual studies, we conducted this meta-analysis by pooling all currently available case-control studies to estimate the effect of p53 codon 72 Arg/Pro polymorphism on cancer susceptibility in Iranian population. Methods: A comprehensive search was undertaken and primary data from all peer-reviewed journals indexed in PubMed, Google Scholar, Scopus, Magiran, Scientific Information Databank (SID), Iran Medex, and CAB abstract electronic were used to conduct this meta-analysis. We considered some exclusion and inclusion criteria to select the articles. Statistical heterogeneity was explored using the I-square. Publication bias was assessed graphically and statistically by Begg's funnel plot and Egger test. All statistical analyses were performed using StatsDirect software and a two- tailed test. P-value less than 0.05 was considered statistically significant for any test. Results: Our dataset, which included 35 case-control studies, consisted of 2426 cancer cases and 2928 controls. Pooled OR and 95%CI indicated that codon 72 Arg>Pro polymorphism was not associated with odds of developing cancer among Iranian population in the dominant model (Pro/Pro+Arg/Pro vs. Arg/Arg: OR= 0.96, 95%CI= 0.74 to 1.24 chi2= 0.06, p= 0.8). Moreover, no significant association was detected in variant allele (Pro vs Arg: OR= 1.075, 95%CI= 0.91 to 1.25), homozygous (Pro/Pro vs Arg/Arg: OR=0.911 95%CI= 0.66 to 1.25), and heterozygous (Arg/Pro vs Arg/Arg: OR= 0.84, 95%CI= 0.7 to 1). Conclusion: Our study revealed that p53 codon 72 Arg>Pro polymorphism was not associated with overall cancer odds in Iranian population.

A seroprevalence and relationship survey of brucellosis between pregnant women and women with spontaneous abortion in Iran.

Background: Brucellosis is one of the most prevalent diseases common between humans and animals. It is also called Malta fever, Undulant fever and Mediterranean fever. This disease is spread by consuming milk and its unpasteurized derivatives. Clinical symptoms of brucellosis in humans are fever, chills, headache, muscular pain, tiredness, loss of appetite, joint pain, weight loss, constipation, sore throat, and dry cough. The present study aimed at surveying the seroprevalence of brucellosis in pregnant women and those women who suffered from spontaneous abortion. Methods: This case- control study was conducted in Sanandaj (Iran) in 2016 and included 2 groups of pregnant women: one group included 160 pregnant women and the other included 160 women who suffered from spontaneous abortion. Then, the participants were asked to fill out the questionnaire. After receiving permission from an obstetrician, a 10-cc blood sample was taken from each person to be used in the Rose Bengal, Wright, 2ME, and Coombs tests. Independent samples t test and Chi-square test were used to analyze the data and compare the groups. Results: Mean±SD age of women in the case group was 30.9±7.3 years, while it was 27.74±5.41 years in control women. The Rose Bengal, Wright, and 2ME prevalence for both groups was negative, but the Coombs and Wright tests score was 33 (20.6%) in pregnant women and it was 27 (16.9%) in women who experienced spontaneous abortion. No meaningful relationship was observed between spontaneous abortion and brucellosis (p= 0.39). Conclusion: Even though the present study did not find a meaningful relationship between spontaneous abortion and brucellosis (p=0.39), high brucella seroprevalence rates between both groups of women indicated that screening tests should be considered before gestation as an appropriate therapeutic strategy.

Different frequencies and effects of ABCB1 T3435C polymorphism on clinical and laboratory features of B cell chronic lymphocytic leukemia in Kurdish patients.

Finding the effects of gene polymorphism on cancer pathogenesis is very desirable. The ATP-binding cassette is involved in drug metabolism, and the polymorphism of this gene may be an important risk factor in B cell chronic lymphocytic leukemia (B-CLL) or progression and/or response to chemotherapy agents. For the first time, the present study was aimed to evaluate the probable effects of ABCB1 T3435C polymorphism on clinical and laboratory features of Kurdish patients with B-CLL. This descriptive analytical case-control study was performed on 50 B-CLL patients and 100 healthy subjects. Serum levels of beta-2-microglobulin (B2M) and lactate dehydrogenase (LDH) and blood WBC, RBC, Plt and ESR were measured. The T3435C polymorphism of the ABCB1 gene was determined by PCR-RFLP. Concentration of serum and blood markers was significantly higher in the malignant group than in the benign subjects. The CC genotype had the highest frequency (66%) in the patient groups. There are no significant differences between the genotypes and type of treatment. Our results demonstrate the high frequency of C allele of ABCB1 T3435C in B-CLL patients with Kurdish ethnicity. We also show that this polymorphism has a significant risk factor in B-CLL. However, the effect of this polymorphism on clinical and laboratory characteristics of B-CLL patients was not significant.

Anti-cyclic citrullinated peptide (CCP) antibody in patients with wood-smoke-induced chronic obstructive pulmonary disease (COPD) without rheumatoid arthritis.

Citrullination, a post-translational modification of proteins, is increased in inflammatory processes and is known to occur in smokers. It can induce anti-cyclic citrullinated peptide (CCP) antibodies, the most specific serologic marker for rheumatoid arthritis. Thus far, the incidence of autoimmunity in patients with wood-smoke-induced chronic obstructive pulmonary disease (COPD) resulting in anti-CCP production has not been examined. We hypothesise that anti-CCP antibody level in these patients should be higher than that in healthy subjects. A total of 112 non-rheumatoid arthritis patients, including 56 patients with wood-smoke-induced COPD and 56 patients with tobacco-induced COPD, and 56 healthy non-smoker controls were included. The serum anti-CCP antibody levels were measured and compared between the groups and against smoke exposure and clinical characteristics. The mean anti-CCP antibody levels in wood-smoke-induced COPD group were significantly higher than those in tobacco-induced COPD group (p = 0.03) and controls (p = 0.004). Furthermore, 8 (14.2 %) patients with wood-smoke-induced COPD, 4 (7.14 %) with tobacco-induced COPD and 2 (3.57 %) controls exceeded the conventional cut-off of anti-CCP antibody positivity. No relationship was found between the anti-CCP antibody level and age, gender, duration of disease, Pack-years of smoking, and duration of exposure to wood smoke. Moreover, correlations between anti-CCP antibodies and severity of airflow limitation, CAT scores, mMRC scores of dyspnoea, and GOLD staging of COPD severity were not significant. Wood-smoke-induced COPD could significantly increase the anti-CCP antibody level in non-rheumatoid arthritis patients when compared with that in patients with tobacco-induced COPD and healthy controls.

Prevalence and occurrence rate of Mycobacterium tuberculosis Haarlem family multi-drug resistant in the worldwide population: A systematic review and meta-analysis.

BACKGROUND: Transmission of Mycobacterium tuberculosis (M. tuberculosis) can occur in different ways. Furthermore, drug resistant in M. tuberculosis family is a major problem that creates obstacles in treatment and control of tuberculosis (TB) in the world. One of the most prevalent families of M. tuberculosis is Haarlem, and it is associated with drug resistant. Our objectives of this study were to determine the prevalence and occurrence rate of M. tuberculosis Haarlem family multi-drug resistant (MDR) in the worldwide using meta-analysis based on a systematic review that performed on published articles. MATERIALS AND METHODS: Data sources of this study were 78 original articles (2002-2012) that were published in the literatures in several databases including PubMed, Science Direct, Google Scholar, Biological abstracts, ISI web of knowledge and IranMedex. The articles were systematically reviewed for prevalence and rate of MDR. Data were analyzed using meta-analysis and random effects models with the software package Meta R, Version 2.13 (P < 0.10). RESULTS: Final analysis included 28601 persons in 78 articles. The highest and lowest occurrence rate of Haarlem family in M. tuberculosis was in Hungary in 2006 (66.20%) with negative MDR-TB and in China in 2010 (0.8%), respectively. From 2002 to 2012, the lowest rate of prevalence was in 2010, and the highest prevalence rate was in 2012. Also 1.076% were positive for MDR and 9.22% were negative (confidence interval: 95%).0020. CONCLUSION: Many articles and studies are performed in this field globally, and we only chose some of them. Further studies are needed to be done in this field. Our study showed that M. tuberculosis Haarlem family is prevalent in European countries. According to the presence of MDR that was seen in our results, effective control programs are needed to control the spread of drug-resistant strains, especially Haarlem family.

Left ventricular mechanical dyssynchrony after chemotherapy in breast cancer patients with normal rest gated SPECT-MPI.

OBJECTIVES: Early diagnosis of chemotherapy-induced cardiotoxicity plays an important role in preventing heart failure. The main aim of our study was to assess left ventricular (LV) dyssynchrony measured by phase analysis of gated single-photon emission computed tomography (SPECT) as an early sign of cardiotoxicity after breast cancer chemotherapy. METHODS: This cross-sectional study was conducted on patients with stage ≤ 3 breast cancer and no history of cardiovascular disease or diabetes. After mastectomy, the patients underwent rest gated SPECT myocardial perfusion imaging (MPI). Sixty patients with normal gated SPECT-MPI were selected and the imaging was performed after chemotherapy with doxorubicin, cyclophosphamide and paclitaxel. LV function and contractility parameters were extracted by QGS software and the results were compared with the t test method. The abnormality of at least one of the three phase analysis indices was considered as left ventricular dyssynchrony (LVD). RESULTS: The average LV end-systolic volume and ejection fraction (LVEF) before and after chemotherapy were (16.2 ± 8.0 ml and 21.6 ± 11.6 ml) and (73.4 ± 7.9% and 67.5 ± 9.2%) respectively, which showed a significant decrease (P < 0.05). In 2 patients (3.3%), the LVEF decreased to less than 50% after chemotherapy. The average parameters of left ventricular contractility before and after chemotherapy were, respectively, as follows: PHB (24.1 ± 7.5 and 33.8 ± 16.4), PSD (9.4 ± 6.1 and 5.7 ± 1.9) and entropy (28.9 ± 7.1 and 35.6 ± 9.7), which showed a significant increase (P < 0.05). LVD was observed in 14 patients (23.4%) after chemotherapy and prevalence of LVD was significantly higher in patients who had received a cumulative dose of doxorubicin of more than 400 mg/m2 (P = 0.005). There was no relationship between age and body mass index with the incidence of LVD after chemotherapy (P > 0.05). CONCLUSION: Using phase analysis of gated SPECT-MPI, chemotherapy-induced LVD was seen in a significant number of patients with breast cancer, especially with a high cumulative dose of doxorubicin. LVD might indicate chemotherapy-induced cardiotoxicity before LVEF becomes abnormal.

Relationship between Vaginal Bacterial Infections and Pregnancy Outcomes: A Systematic Review and Meta-Analysis.

Background: Bacterial infections are among the most serious infections worldwide. They can cause miscarriage, premature birth, stillbirth, and ectopic pregnancy in pregnant women. The aim of this study was to investigate the relationship between bacterial infections and pregnancy outcomes through a systematic review and meta-analysis. Materials and Methods: PubMed, Scopus, Web of Science, and Embase databases were searched from January 2000 to December 2018 using appropriate keywords to identify related articles. The final related studies were selected and evaluated using the Newcastle-Ottawa Scale (NOS). Results: Results of this meta-analysis based on combining case-control studies showed that the presence of bacterial infections could lead increase in the odds of all pregnancy outcomes like premature infant birth (odd ratio [OR]: 1.50; 95% Confidence Interval [CI], 1.39-1.61), preterm delivery (OR: 1.54; 95% CI, 1.39-1.70), abortion (OR: 1.16; 95% CI, 1.04-1.29), stillbirth (OR, 1.29; 95% CI, 1.12-1.49), and ectopic pregnancy (OR: 1.12; 95% CI, 1.05--1.19). The results showed that the Risk Ratio (RR) of preterm delivery in pregnant women with vaginal infections was 1.57 (95% CI, 1.46-1.67), whereas the RR of abortion was 2.02 (95% CI, 1.72-2.38). Conclusions: Based on the results of this meta-analysis, the presence of bacterial infections in pregnant women can lead increase in the risk of pregnancy outcomes especially, preterm delivery, abortion, stillbirth, and ectopic pregnancy. Therefore, it is necessary for obstetricians and gynecologists to pay attention to the diagnosis of these infections in women before pregnancy and during pregnancy in order to prevent the consequences of these infections.